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Ankle arthritis causes

24 Sep 18

Arthritis of the ankle joint - causes, manifestations, diagnosis, treatment and prevention

A fairly common and significantly younger disease of the leg joints in recent years is ankle arthritis. Anyone without exception can suffer from it - older people, young people and even children.

Awareness about the symptoms and causes of the disease, careful attention to one’s own body, proper nutrition, giving up bad habits - this is the necessary minimum effort of every person to prevent ankle arthritis. Do not try, even if informed, to treat the disease yourself; be sure to seek medical help.

Arthritis of the ankle joint - characteristics

Arthritis of the foot, like any inflammation of the joint, is accompanied by quantitative and qualitative changes in the synovial fluid. Let us recall that the joint is surrounded by an articular capsule, which is lined from the inside with a synovial membrane that produces synovial fluid.

This fluid acts as a lubricant, facilitating friction of the articular surfaces. In addition, synovial fluid delivers nutrients to the articular cartilage and removes metabolic products from it. After all, as you know, cartilage in a joint is devoid of blood vessels.

Due to the above reasons, the synovial membrane is first affected and synovitis develops. The inflamed synovial membrane secretes an excess amount of fluid, which causes swelling of the joint.

With arthritis, synovial fluid, even in excess quantities, cannot perform the functions assigned to it, as a result of which not only articular cartilage suffers, but also bone tissue, ligaments, and connective tissue.

Arthritis of the ankle joint is based on inflammatory processes that cause swelling, hypermia and destruction of the joint surfaces. In advanced forms of arthritis, partial or complete deformation of the joint occurs, up to the fusion of elements, the so-called “ankylosis.”

In fact, the term foot arthritis can mean about a hundred different pathologies with one common property. Each of the pathologies causes inflammation. The inflammatory process manifests itself as pain, swelling and eventually leads to immobilization of the joints.

The disease is diagnosed quite often, and in most cases, patients seek help when complications and pronounced symptoms occur. Damage to the joint structures in this case inevitably leads to a decrease in a person’s quality of life and can even cause disability.

Considering this, it is important to promptly begin adequate treatment of orthopedic pathology with mandatory subsequent rehabilitation.

It should be noted that inflammation of the joints, although in many cases has similar features, is formed in different ways. For example, rheumatoid arthritis of the foot develops against the background of an autoimmune process.

Microbial toxins combine with the body's antibodies in the so-called. immune complexes that attach to the connective tissue of the joint. The body's immune system, trying to destroy these complexes, destroys its own connective tissue.

In case of open intra-articular injuries, the infection penetrates into the articular cavity through the wound gate, and in reactive arthritis it is carried in by current from other organs. With gouty arthritis, uric acid salts (urates) accumulate in the joint cavity, and with diabetes mellitus, the entire foot suffers due to impaired blood circulation, including. and her joints.

The disease occurs at any age, including children (even newborns) and adolescents; it usually affects one large joint of the lower or upper limb, sometimes medium and small joints; In rare cases, inflammation of several joints may occur.

There is a certain connection between the age of the patient and the type of pathogen:

  • Infectious arthritis in young sexually active people is most often caused by gonococcus. Gonococcal arthritis is also observed in newborns, to whom the pathogen enters during the perinatal period from the body of a mother suffering from gonorrhea.
  • The second place in frequency of occurrence (in all age groups) is arthritis caused by Staphylococcus aureus.
  • Joint lesions are less common
    • streptococci;
    • Pseudomonas aeruginosa (with immunodeficiency, in young children, elderly people, weakened patients, with open trauma);
    • Haemophilus influenzae (in young children): other microorganisms.
    • Unusual rare pathogens (fungi, opportunistic microorganisms, etc.) may occur in arthritis in immunocompromised patients.
    • The prognosis of treatment largely depends on how early the arthritis was detected. The results of therapy and its duration can also be influenced by the type of disease being diagnosed.

      In adults, the disease is most often a consequence of improper load on the joints, and is often found in athletes (runners, gymnasts, speed skaters, dancers), as well as in people in menopause, which is associated with changes in the hormonal system of patients.

      In young children, arthritis can manifest itself due to nutritional disorders (lack of protein compounds, calcium, phosphorus, vitamin D in food) or occur due to a reaction to certain allergens (food, dust, pollen, animal dander).

      Factors that provoke the development of ankle arthritis may include:

    • Sudden hypothermia.
    • Excess body weight.
    • Violation of metabolic processes.
    • Hormonal imbalance.
    • Low immune status of the body.
    • Walking in high heels and wearing tight shoes.
    • Professional activities (ballerinas, athletes).
    • Hereditary factor.
    • Allergic conditions.
    • Bad habits.
    • Flat feet.
    • Inflammation in the ankle can be caused by many reasons, let’s take a look at the main ones:

      1. Traumatization of joints and ligaments or increased load on the same joint (sprains, subluxations, fractures), flat feet. When a joint is overloaded, prolonged mechanical damage occurs, micro-tears of the meniscus, cartilage and ligaments.
      2. own immunity in relation to joint tissues is the development of processes of an autoimmune nature, when the body produces antibodies and damages its own cells, accepting them as foreign (rheumatoid arthritis).
      3. Viral or bacterial infections in which the articular surface, bursa and other parts of the joint become infected with pathogenic bacteria, protozoa and other pathogenic flora. Depending on the pathogen, there are:
        • specific forms of the disease (gonococcus, chlamydia, spirochete pallidum
        • nonspecific, when the disease is secondary in response to sore throat, influenza, furunculosis;
        • Infection with staphylococcus, streptococcus.
        • Dystrophic changes in joints (osteoarthrosis).
        • Systemic diseases (Bechterew's disease, lupus erythematosus, scleroderma).
        • Specific diseases such as psoriasis (an immune failure occurs in the body, psoriatic plaques penetrate deep into the joints) and gout, associated with metabolic disorders and the deposition of uric acid crystals in the joints, also cause an inflammatory process.
        • In some cases, the cause is urogenital or intestinal infections, which can cause reactive arthritis of the ankle joint. This type of disease occurs several days or even weeks after the onset of acute prostatitis, urethritis, vaginitis, enterocolitis.

          The following also contribute to the development of the disease:

        • Metabolic disorders (diabetes mellitus, gout).
        • Rheumatism, tuberculosis, syphilis, gonorrhea.
        • Tendency to violent allergic reactions.
        • Deficiency of vitamins and macroelements, poor nutrition or prolonged fasting.
        • Hypothermia, living in conditions of high humidity.
        • Bad habits: drug addiction, alcoholism, physical inactivity.
        • Diseases of the circulatory system (veins and capillaries).
        • Chronic foci of infection in the body (osteomyelitis, pyelonephritis, myocarditis, sinusitis, tonsillitis, otitis).
        • Natural wear and tear of joints, aging of the body.
        • Classification by types, forms and degree of development

          Arthritis of the ankle joint is divided into classifications according to types, forms of manifestation, severity, types and number of joints involved.

          Classification of arthritis by type occurs depending on the nature of its occurrence and the characteristic features of its manifestation. Among the most common types of arthritis in practice, the following should be noted:

        • reactive - occurring against the background of an infectious disease of the mucous membranes or skin infections;
        • periarthritis - characterized by inflammation of the periarticular tissues;
        • traumatic - associated with ankle injury;
        • gouty - resulting from an increase in the amount of uric acid, which begins to be deposited in tissues and joints;
        • arthrosis-arthritis - occurs at the stage of complete destruction of cartilage;
        • Rheumatoid arthritis is a systemic inflammation of the joint, in which, as a result of a genetic predisposition, a person feels the effects of adverse weather conditions.
        • Each type of arthritis has two main forms:

          The first form is usually accompanied by significant pain. As for the chronic form, it is aggravated by other joint disorders, up to their complete destruction.

          If the disease is advanced, then within a couple of years a clear thickening of the ankle may begin to develop, in which the foot will have an unnatural position. In the absence of adequate treatment, the patient faces difficulty walking and bending the leg, as well as noticeable atrophy of the calf muscle.

          We can roughly distinguish three main phases of the course (severity) of the disease:

          • The first degree is characterized by minor periodic pain and a certain tension in the ankle joint. General symptoms of malaise are noted. It is at this stage that it is very important to seek qualified help. If the first degree of arthritis is not treated, then the person will eventually have the second and third degrees.
          • The second degree is characterized by more pronounced pain in the joint, especially when walking and other stress on the legs. In this case, the pain is already systematic and does not go away even during a night’s sleep. The affected areas have noticeable swelling and redness. Also, during exercise, you can notice a crunching sound specific to arthritis. At this stage of the disease, joint deformation begins to occur.
          • The third degree is a consequence of untimely treatment of the first two phases of arthritis. At this stage of the disease, significant deformation of the ankle joint can be noted. The patient has difficulty walking and independent movement is already questioned. Most often, this advanced form can lead to disability and complete loss of ability to work.
          • Based on the number of joints involved, the disease is divided into mono- or polyarthritis

            Reactive arthritis is inflammation of the joints that occurs against the background of an infectious disease of the stomach, intestines or genitourinary system. As a rule, the first signs of the disease are detected within a month after infection.

            Reactive arthritis is more common in young men and is associated with diseases such as gonorrhea and chlamydia. It should be noted that in case of food poisoning, both men and women are equally susceptible to inflammation of the joints.

            The disease can be caused by a variety of bacteria that are localized in the genitals, urethra or urinary cavity. Hereditary predisposition plays an important role here.

            In this regard, it is customary to distinguish between two types of arthritis. Namely:

          • Primary - occurs due to a malfunction of a healthy body. The first symptoms of rheumatoid arthritis of the foot most often occur unexpectedly for the patient. Tracing and identifying catalysts for inflammation is quite problematic.
          • Secondary - in this case we are talking about an inflammatory process that provoked a related disease. Tuberculosis, gonorrhea, syphilis and even influenza and ARVI can cause infection to enter the joint cavity and, as a result, inflammation.
          • When diagnosing foot arthritis, attention is paid to the pronounced symptoms of the pathology, as well as to the results of an ultrasound examination. The presence of arthritis is indicated by two main groups of symptoms:

          • Specific are signs that are unique to this disease. These include: morning stiffness, simultaneous arthritis of several small joints of the foot (inflammation begins to be multiple in nature, especially often this indicates an infectious lesion), characteristic hallux valgus, the presence of a rash, heel pain.
          • Nonspecific - these symptoms can relate to any type of pathology. We are talking about: severe pain, the presence of deforming arthritis of the foot, accumulation of synovial fluid (can be determined by palpation), disruption of the basic functions of the joint, crunching when bending the fingers or foot. Moreover, over time, any of the arthritis (with the exception of post-traumatic ones) begins to affect the functioning of a person’s internal organs.
          • Acute arthritis of various locations and different origins have similar symptoms:

          • Temperature reaction. In acute arthritis, in most cases there is a febrile fever with a sudden onset - the patient's temperature rises sharply to 39°C or higher, chills and profuse sweat are often noted.
          • Pain. The pain syndrome is severe and usually develops sharply; in some cases, before the pain is localized in one joint, migrating unexpressed pain sensations in several joints may be observed.
          • Joint changes with dysfunction. Swelling and redness of the skin appears over the affected joint, and it becomes hot and painful to the touch. The function of the joint is impaired initially due to swelling and pain that limits movement. As the process progresses, destruction (destruction) of cartilage tissue occurs, and in severe cases, bone tissue - as a result, the normal function of the joint is lost forever.
          • Intoxication. In acute arthritis, the well-being of patients sharply worsens, signs of general intoxication appear: pale skin, weakness, lethargy, sweating, nausea (vomiting is possible against a background of high temperature), headache, dizziness, decreased or complete lack of appetite.
          • With purulent arthritis of large joints and treatment started late, a picture of sepsis or infectious-toxic shock appears: the temperature exceeds 40°C; there is confusion or loss of consciousness; rave; blood pressure drops; pale skin with a bluish tint; pulse is frequent and weak.

            Chronic arthritis is characterized by mild symptoms:

          • There may be no temperature at all, or it may be subfebrile (within 37.5°C), inconsistent.
          • The pain is of low intensity and is intermittent; sometimes there are painful attacks.
          • There is often no hyperemia, the swelling is weak, almost invisible upon examination.
          • The function of the joint is partially preserved: passive and active movements are possible, but to a limited extent due to moderate pain or contractures.
          • Symptoms of intoxication include general weakness, drowsiness, decreased appetite, and sweating.
          • In the case of tuberculous arthritis, a specific symptom is noted - pale, not hyperemic skin over a swollen joint (“pale tumor”). With a long course of tuberculous arthritis, fistulas can form with the release of a thick, cottage cheese-like mass (caseous masses).

            Despite the absence of external signs, a fairly rapid destruction of the joint from the inside occurs, up to the development of irreversible changes. The danger of chronic arthritis is that patients do not immediately consult a doctor, postponing examination and treatment - after all, the pain does not bother them too much.

            As a result, the joint is damaged and full treatment becomes impossible. Advanced cases of chronic arthritis can cause disability.

            In children, septic arthritis occurs somewhat differently than in adults:

          • the onset of the disease is acute, sudden;
          • the course is often severe and extremely severe, with hectic fever and significant intoxication;
          • inflammation is accompanied by the formation of a large amount of exudate, leading to severe swelling, pain and an almost complete lack of mobility.
          • With ankle arthritis, you may experience:

          • destruction of the joint of varying severity - from minimal changes, recovering within several months, to deep damage to the bone and cartilage, leading to irreversible dysfunction up to the complete absence of movement in the joint;
          • transfer of infection to nearby bones and skin (osteomyelitis, phlegmon);
          • in children, purulent inflammation can cause destruction of the growth plate, which will manifest itself with age as shortening of the limb;
          • sepsis;
          • infectious-toxic shock;
          • death from shock or multiple organ failure.
          • If adequate treatment is not provided, then after about two years complete destruction of the articular cartilage in the ankle may occur. Visually, there is a thickening in the area of ​​the affected joint, it takes on an unnatural position, independent walking is difficult, passive movements are difficult, and may even be completely impossible.

            For a doctor, the correct diagnosis plays a decisive role, since the symptoms of ankle arthritis have a number of common features with other pathologies with similar manifestations. For example, it can be difficult to distinguish chronic arthritis from arthrosis or arthropathy, and often these diseases are present at the same time.

            Therefore, if you find yourself with the symptoms described above, hurry up and get tested as soon as possible. Here are the diagnostic methods that are usually used in arthrological practice:

          • General blood and urine tests. Since the body reacts to any inflammatory process, the doctor will be able to see changes in the composition of biological fluids that are characteristic of this or that form of the disease. However, it is impossible to determine the area of ​​the inflammatory process from them.
          • An immunological blood test will show the presence of antibodies to a particular pathogen in the blood. This will help the doctor choose the right drug therapy tactics.
          • A biochemical blood test is done to measure the concentration in the blood of various chemicals formed in the body during life. For example, in arthritis, this test will help identify specific markers and thus distinguish ankle arthritis from arthrosis or arthropathy.
          • An x-ray of a joint with ankle arthritis will differ significantly from the picture of other pathologies. During the inflammatory process, the joint cavity is filled with fluid or pus, which means that the surfaces of the articulating bones will be somewhat distant from each other. However, this method has disadvantages because it does not allow ligaments and soft tissue to be seen.
          • Magnetic resonance imaging is a more informative method compared to x-rays. Allows you to detect the slightest deviations from the norm, changes in ligaments, articular cartilage and other important structures of the joint. The method is very informative.
          • Computed tomography (CT) is also a popular and quite informative method of layer-by-layer X-ray images. If MRI examination is contraindicated for the patient, CT is an alternative option.
          • Ultrasound – ultrasound examination of the ankle. Allows you to see changes in soft tissues and the joint cavity. However, only a qualified specialist can correctly evaluate the result.
          • Arthroscopy – diagnosis and treatment at the same time. This is a surgical operation performed using miniature optical instruments that are inserted into the joint cavity. The doctor can examine the joint from the inside, remove inflammatory fluid from it, stop bleeding, etc.
          • During the interview and history taking: the nature of the pain in the joint and other complaints (limitation of movement, temperature, etc.) are clarified; pay attention to the presence of risk factors, indication of possible foci of chronic infection (tonsillitis), recent acute infectious diseases; assess the general condition of the patient and local changes (swelling, hyperemia, pain on palpation, degree of dysfunction).

            A mandatory study that confirms the diagnosis of infectious arthritis and establishes its immediate cause (pathogenic microorganism) is a joint puncture with collection of synovial fluid.

            The resulting liquid is subjected to microscopy, biochemical analysis and inoculation on nutrient media to determine sensitivity to antibiotics. With infectious arthritis, a large number of leukocytes are found in the synovial fluid, and the glucose level decreases (especially during a purulent process).

            X-ray diagnostics are not informative in acute arthritis (since bone changes appear no earlier than 10 days from the onset of the disease), but are necessarily carried out to clarify the condition of the bones. In chronic arthritis, x-rays reveal characteristic signs of joint destruction.

            Statistics show that most patients seek help already at the second stage of the disease. Once the etiology has been identified and the diagnosis has been made, treatment must be started immediately.

            Non-drug treatment of the disease

            The following may be involved in the treatment of arthritis:

          • Infectious disease specialist – for purulent arthritis.
          • Traumatologist – for post-traumatic arthritis.
          • Therapist – for damage to internal organs, which is often found in rheumatoid arthritis.
          • An endoscopist is a doctor who performs arthroscopy and other studies that require special equipment.
          • Surgeon – if surgical treatment of arthritis is necessary.
          • Chiropractor – when prescribing massage to patients with arthritis.
          • After making a diagnosis, specialists apply non-drug and drug treatment to the patient. Non-drug treatment includes the following measures:

            1. Providing peace. The affected joint should be protected from any stress. Ideally, therapy should take place while maintaining bed rest. If the patient does not have this opportunity, then the joint immobilization method is used, that is, applying an elastic bandage.

            2. It is also recommended to use auxiliary support objects (cane or crutches) when walking. These also include orthopedic shoe inserts and specially shaped boots with soles that reduce the load on the foot when moving.

            3. Proper nutrition. If you have arthritis, it is very important not to eat foods that are harmful to the structures of the musculoskeletal system. We are talking about fatty and fried foods, products with preservatives and various chemical additives. You should adhere to a natural, balanced diet, focusing on eating fruits, vegetables, seafood, nuts, and herbs

              This approach will improve metabolic processes in the body, which is very important for the restoration of the affected joint. Proper nutrition is especially indicated for overweight patients, since large body weight negatively affects the condition of the joints of the lower extremities.

            4. Cryotherapy. Cold therapy has been used successfully to combat arthritis for many decades. A specially developed technique has a beneficial effect on sore joints, helps relieve inflammation, reduce the severity of pain, and reduce the severity of inflammatory processes in tissues. Other physiotherapeutic procedures have the same effect: ultrasound, hydromassage, fluid therapy.
            5. Exercises. A complex of exercise therapy intended for the treatment of arthritis must be performed by the patient without fail. Gymnastics play a key role in the process of restoring a damaged joint. Exercise therapy helps relieve pain, increase the strength of the muscles surrounding the joint, and reduce tension in the ankle. Such measures will prevent tissue atrophy and improve limb mobility. It is good to combine exercise with long walks in the fresh air.
            6. Manual mobilization. It is used to restore the functioning of the joint and normalize the sliding of its surfaces, and specifically its mobility. Mobilization must be carried out correctly, only in this case the mechanics in the connection will improve.
            7. Sanatorium treatment. Indicated for almost all types of pathologies of the musculoskeletal system, including effective in arthritis. In the conditions of sanatorium treatment, it is possible to provide a diseased joint with full-fledged therapy, including: mud therapy, balneotherapy, deep heating, hydromassage.
            8. The following methods of treating arthritis are also widely used:

            9. Hirudotherapy - treatment with leeches is especially effective if there are problems with the synthesis of substances in the body. During hirudotherapy, congestion is eliminated and the human immune system is activated. The procedure is indicated during the period of non-exacerbation, but exceptions may be made for certain diagnoses.
            10. Homeopathy is taking medicines in concentrated doses. With the help of homeopathy, it becomes possible to establish metabolic processes and also relieve acute processes in the body. The effectiveness of treatment largely depends on the qualifications of the homeopath.
            11. Mud therapy. For damaged joints, clay treatment is necessary. The healing soil contains minerals necessary for the restoration of bone and cartilage tissue. During mud therapy, the joint warms up and pain is blocked.
            12. It is necessary to understand that in any treatment there is nothing more or less important. All that really matters is that the therapy is carried out regularly and under the supervision of a professional specialist. Then you will be able to avoid serious and irreparable consequences that can have a very negative impact on the quality of your life.

              Drug and surgical treatment

              Let us remember that chronic arthritis of the ankle joint must be treated systematically and comprehensively. Drug therapy in this case does not lead to a complete cure, but only provides an anti-inflammatory and diuretic effect. The effects of the drugs reduce swelling and relieve inflammation of the joints.

              For each of the above arthritis, specific therapy methods are used to combat inflammation catalysts. There is also a standard course of treatment for this disease, including:

            13. Antibiotics. If the arthritis is bacterial, then the patient is prescribed Levomycytin, Tetracycline. Since antibiotics have a negative effect on the functioning of internal organs, before prescribing them, it is necessary to identify the source of inflammation. Heat in the foot indicates an infection of the joints. Properly selected antibiotics speed up healing time.
            14. Nonsteroidal drugs. To relieve swelling and swelling, NSAIDs are prescribed. Widely used NSAIDs include: Diflonizal, Aspirin, Celecoxib, Ibuprofen, Indomethacin, Ketoprofen, Etodolac and others. The course of therapy ranges from 7 to 10 days. If, after completing the course, it hurts the patient to step on his foot, corticosteroids are additionally used. Relief occurs after 2-3 injections.
            15. Specific drugs. Gout requires the use of medications that help remove uric acid. Rheumatoid arthritis of the top of the foot and small joints requires the use of medications that block the immune system.
            16. Ointments for rheumatoid arthritis have a local analgesic effect. Ointments gently warm the tissues and help reduce swelling. The ointment must be used carefully. It only relieves symptoms, but does not eliminate the cause of inflammation.
            17. Chondroprotectors are used as restorative therapy. Chondroprotectors are especially effective at the initial stage of disease development.
            18. When the question arises of how to treat ankle arthritis, it is better to consult a specialist for an answer, since taking measures on your own can only worsen the situation.

              For arthritis, it is recommended to take:

            19. Vitamin C. Essential for many biological processes throughout the body, including the synthesis of collagen, the substance that makes up cartilage tissue. It is also a natural antioxidant, that is, it protects tissues from the destructive effects of oxygen free radicals formed during any inflammatory process. Patients with arthritis are recommended to take 100 mg of vitamin C 4 to 5 times a day.
            20. Vitamin B3 (niacin). Nicotinic acid has a vasodilating effect, which improves microcirculation in the affected joints and promotes rapid healing of damage during the recovery period.
            21. Vitamin B5. Stimulates the release of steroid hormones (glucocorticoids) by the adrenal glands, which have a pronounced anti-inflammatory effect.
            22. Vitamin E. Has a powerful antioxidant effect, preventing tissue damage from toxic products formed during the breakdown of cells at the site of inflammation. The daily requirement for this vitamin for adults is 8 - 10 international units (IU), and for children - 3 - 7 IU.
            23. Foot arthroplasty is prescribed only after traditional drug treatment has failed. Indications for surgical treatment are: severe pain, complete loss of mobility and performance, the influence of the inflammatory process on the functioning of other internal organs, severe deformation of the transverse ankle joint, the presence of necrotic phenomena.

              In this case, prosthetics is the only way to effectively cure the disease. If the patient has been registered as disabled, after arthroplasty, due to the restoration of mobility, the group is reviewed.

              Leading European clinics give preference to minimally invasive surgical methods. Arthroplasty requires only a few small incisions, through which all other manipulations are performed. Before the operation, X-rays must be taken to help see the location and extent of the lesion.

              In difficult cases, ankle replacement can be performed using an ultrasound machine or tomograph. Diagnostics allow the surgeon and staff to monitor manipulations and adjust them as necessary

              In addition to medications and surgery, for more effective therapy, the patient is expected to: strictly follow the recommendations, eat properly, and perform special exercises for the feet every day.

              Complications of the disease

              Advanced forms of arthritis can result in very undesirable consequences for the patient in the form of deformation of the ankle joint, limitation of independent movement, and disability.

              The disease has become significantly younger in recent years. Most cases of the disease, if detected early, can be treated with conservative methods without surgery. In this case, you can preserve the integrity of the ankle joint and avoid irreparable consequences that can affect your entire future life.

              Arthritis itself can be complicated by:

            24. Osteoporosis. This term refers to a decrease in bone mass combined with a decrease in bone density. The cause of this complication is considered to be a long-term, sluggishly progressive systemic inflammatory process observed in rheumatoid and other rheumatoid arthritis. An increased concentration of pro-inflammatory (supporting the inflammatory process) mediators stimulates the process of destruction of bone tissue and leaching of calcium salts from it. In addition, physical inactivity (reduced physical activity) contributes to bone destruction, which develops as a result of increased pain when moving the joints. Of no small importance is the use of cytostatic (slowing down the processes of cell division) drugs (methotrexate, cyclosporine) in the treatment of rheumatoid arthritis. First of all, the pathological process affects the articular surfaces of the bones in the area of ​​the affected joints, but later generalized osteoporosis may occur.
            25. Amyloidosis. This disease is characterized by the formation of pathological amyloid protein in the body, which accumulates in various tissues (kidneys, organs of the gastrointestinal system, etc.), gradually destroying them. Amyloid is formed in mutated cells of the immune system, which is observed in long-term progressive inflammatory diseases in the body.
            26. Spread of infection. With purulent arthritis, the capsule of the hip joint may melt and the infection may spread to surrounding tissues (ligaments, muscles, bones, subcutaneous fat, etc.). The infection can also spread throughout the body as a result of damage to blood vessels and the penetration of pathogenic bacteria into the blood. This will manifest itself as a deterioration in the patient’s general condition, a more pronounced increase in temperature (up to 41–42 degrees), severe headaches and muscle pain, increased sweating, impaired consciousness, and so on.
            27. Dislocation. With prolonged progression of the inflammatory process in the joint, articular cartilage and intra-articular ligaments may be destroyed, and the articular surfaces of the bones may also be affected. All this leads to a decrease in the strength of the fixing apparatus of the joint, which, with increasing load (for example, during a jump from a height or when lifting a weight), can lead to rupture of weakened ligaments and displacement of the articular surfaces of the bones relative to each other (that is, to dislocation).
            28. Joint contracture. Contracture is a pathological condition manifested by a decrease in the range of motion in a joint due to damage to the muscles, tendons, ligaments or other components of the joint. Contractures can be:
              • Passive - restriction of movements is caused by an anatomical defect in the intra-articular structures, as a result of which both active (performed by the patient himself) and passive (performed by the doctor’s hands) movements in the joint are limited.
              • Active - the amplitude of the movements performed by the patient is reduced, however, passive movements in the joint are possible to varying degrees. The cause of active contractures can be, for example, muscle atrophy (decrease in muscle volume and strength), which develops with prolonged immobility (for example, when applying a plaster cast after joint replacement).
              • Ankylosis. This term refers to the restriction of mobility in a joint due to intra-articular proliferation of bone, cartilage or fibrous tissue. This leads to the connection of the articular surfaces with each other, as a result of which mobility completely disappears (with bone or cartilaginous ankylosis) or is significantly limited (with fibrous ankylosis, in which barely noticeable, extremely painful movements are possible).
              • Treatment with folk remedies

                Traditional recipes can be an excellent addition to the main treatment prescribed by a doctor. However, for arthritis, it is extremely undesirable to rely on traditional medicine alone, since in some cases this can lead to the development of adverse reactions and complications, the correction of which will require much more effort. In any case, before starting to use folk remedies, it is recommended to discuss treatment tactics with a specialist.

                To treat arthritis you can use:

              • Infusion of St. John's wort herb. St. John's wort contains tannins (have an anti-inflammatory effect), vitamins C and E (have an antioxidant effect), rutin (increases the strength of vascular walls) and other substances. To prepare the infusion, take 30–40 grams of crushed herbs, place it in a glass jar and pour a full glass of boiling water. Let it brew in a dark place for 3 - 4 hours, then filter thoroughly and take 1 tablespoon orally 3 times a day (15 - 20 minutes before meals).
              • Calendula infusion. It has anti-inflammatory and antimicrobial effects, and also accelerates the process of wound healing and restoration of damaged tissue. The infusion is prepared as follows - 1 tablespoon (about 5 - 10 grams) of calendula flowers is poured with 1 glass of boiling water, then infused in a dark place at room temperature for 2 - 3 hours. The resulting infusion should be filtered and taken orally up to 1 tablespoon (for adults) or teaspoon (for children) 3 times a day half an hour before meals.
              • Tincture of yarrow herb. The essential oils and tannins contained in this plant have a pronounced anti-inflammatory, antiallergic and antibacterial effect. To prepare the tincture, 30 grams (about 2 tablespoons) of dry crushed yarrow herb should be placed in a glass jar, filled with 1 glass of vodka, tightly closed with a lid and placed in a dark place for 7 - 10 days. After this, the tincture should be strained and taken orally, 1 ml three times a day before meals (dilute 20 drops of tincture in 1 tablespoon of warm boiled water).
              • Echinacea decoction. This plant has an immunostimulating effect, increasing the body's resistance to various viruses and bacteria, as well as stimulating nonspecific immune reactions. To prepare a decoction, 50 grams of crushed Echinacea roots are poured with 400 - 500 milliliters of hot water and kept in a boiling water bath for 30 minutes. After this, allow the broth to cool at room temperature, filter it and take 1 - 2 tablespoons 2 - 4 times a day before meals. The decoction is not recommended for pregnant and breastfeeding women.
              • In addition to the methods described above, traditional medicine suggests using compresses as an effective method of combating arthritis and its manifestations. The main advantages of this method of administering medicinal substances are the rapid and at the same time long-lasting therapeutic effect. Medicinal plants with an anti-inflammatory effect are mainly used. Has an anti-inflammatory effect:

              • Compress made from white cabbage leaves. 1 – 2 fresh cabbage leaves must be passed through a meat grinder. The resulting pulp should be applied to a few folded gauze and applied to the inflamed joint for 2 - 4 hours, wrapping it in a towel.
              • Compress made from nettle leaves. 1 tablespoon of crushed nettle leaves should be poured into 200 ml of boiling water and left for 2 to 4 hours. After this, soak gauze with the resulting infusion and apply to the affected joint for several hours before going to bed.
              • Compress from coltsfoot. Pour 1 tablespoon of crushed dried coltsfoot leaves into 200 ml of water, bring to a boil and boil in a water bath for 15 - 20 minutes. After cooling, soak gauze swabs in the broth and apply them to the inflamed joints for 3 to 5 hours.

            It is recommended to warm up joints with arthritis only after consulting a doctor, since if used incorrectly, this method can lead to the development of serious complications. The fact is that when exposed to heat, blood vessels dilate and microcirculation in tissues improves.

            On the one hand, this improves the delivery of nutrients to damaged tissues and helps flush out toxic products from the source of inflammation. At the same time, improvement of microcirculation can cause the progression of the inflammatory process (with severe activity of rheumatic disease) or the spread of infection through the bloodstream throughout the body (with purulent arthritis).

            That is why thermal procedures are prescribed only for moderate and weak activity of rheumatic diseases, after excluding infectious lesions of the joints. To warm up the joints you can use:

          • Compresses with ozokerite. Ozokerite has the ability to accumulate and retain heat, and also contains various anti-inflammatory and analgesic substances, so it can be used in the treatment of arthritis. To prepare a compress, ozokerite should be melted and soaked in 7-10 layers of gauze, cooled to about 50 degrees and applied to the affected joint, wrapped in several layers of towels or a blanket (to reduce heat loss). The duration of the procedure usually does not exceed 15–30 minutes, and the entire course of treatment includes 15–20 procedures performed daily.
          • Sand or salt. Sifted sand or crushed rock salt should be heated in a frying pan to 50 - 55 degrees, then poured into a cloth bag and applied to the sore joint for 20 - 40 minutes, also covered with a blanket. After the procedure, the foot should be kept warm.
          • Forecast and prevention of ankle arthritis

            In the case of timely treatment and the absence of pre-existing changes in the joints (arthrosis, rheumatoid arthritis, prosthesis), the prognosis is favorable - in approximately 70% of patients there is a complete recovery with restoration of joint function. With concomitant pathology, late or inadequate treatment, and microorganism resistance to antibacterial therapy, irreversible disorders develop in 25-50%.

            Death is possible in deeply weakened patients and in old age. With the development of sepsis against the background of purulent arthritis, mortality continues to remain quite high (up to 15%).

            Prevention comes down to preventing infection of the joints against the background of an infectious disease. If at least one of the risk factors is present, treatment of any infection should be carried out with the mandatory prescription of antibiotics. For penetrating joint injuries, it is necessary to treat the wound in a surgical hospital.

            A number of nonspecific preventive measures can significantly reduce the risk of developing arthritis: a healthy lifestyle and good nutrition strengthen the immune system; the absence of promiscuity sharply reduces the likelihood of developing gonorrheal arthritis; timely detection of tuberculosis (Mantoux test in children and adolescents, fluorography in adults) minimizes the risk of tuberculous arthritis.

            To prevent the development of complications, it is necessary to: carry out the full course of treatment under the supervision of a doctor; monitor the effectiveness of antibacterial therapy by repeated studies of synovial fluid; Upon completion of antibacterial therapy, physical therapy, massage, and physical therapy are required.

            During the recovery period, calcium supplements, chondroprotectors, and multivitamins may be recommended to quickly normalize joint function.

            Prevention of arthritis includes:

          • Adequate treatment of exacerbations of rheumatic diseases.
          • Correct, and most importantly long-term, use of anti-inflammatory and other drugs for rheumatoid arthritis will not only effectively eliminate all clinical manifestations of the disease, but also cause long-term and stable remission.
          • Adequate use of antibiotics for purulent arthritis. Many patients stop taking antibacterial drugs prescribed by their doctor as soon as joint pain disappears and their general condition improves. However, in this case, some pathogenic bacteria located in hard-to-reach tissues (for example, in ligaments or cartilage) may survive, which will soon lead to relapse (re-development of infection). That is why you should take only as much antibiotics as prescribed by your doctor.
          • Proper nutrition. For some forms of arthritis (such as gouty arthritis), nutrition plays a key role in the treatment process. At the same time, it is recommended to follow the diet prescribed by the doctor even after the inflammatory phenomena have subsided, consuming “dangerous” foods only in small quantities, which will reduce the likelihood of relapse.
          • Adequate physical activity. During the period of exacerbation of arthritis and for several weeks after the inflammatory phenomena have subsided, it is recommended to exclude heavy physical work and participation in strenuous sports, as this can lead to more pronounced damage to the inflamed intra-articular components.

          One way to stop the development of ankle arthritis is through special sports exercises that will help increase blood circulation in the ankle area and also strengthen the corresponding muscles. In addition, normal function of the muscles that surround the joint capsule is important for ankle stability. To overcome ankle arthritis, exercises should be started without delay, after consulting with your doctor.

          One of the simplest, but at the same time very effective exercises that helps with ankle arthritis is foot rotation. It primarily helps maintain ankle flexibility. Sit on a chair with a strong back, stretch your leg, straighten your knee. Extend your foot as far as possible, then slowly begin rotating your feet clockwise.

          Do ten 10 turns, rest for a few seconds, then change direction. The exercise can also be done in warm water, sitting on the side of the pool, then this procedure will not be so stressful for the ankle joints.

          Isometric exercises to strengthen muscles also help against ankle arthritis. The idea of ​​such exercises is to expend maximum effort against any resistance within a few seconds.

          For example, here is an exercise that helps prevent ankle arthritis - an exercise with a towel on the floor. Sit on a chair, place a towel on the floor in front of it. Place your bare feet on it so that your toes are on the edge of the towel farthest from you.

          Squeeze the edge of the towel with your toes, hold this position, then relax your leg. Repeat this movement for 10 seconds. Then rest for a few seconds and continue with the other leg. Make sure that your heels are firmly pressed to the floor during the exercise and do not lift them.

          Always remember that the onset of the disease is easier to prevent than to cure, so do not neglect the prevention of ankle arthritis

          Arthritis of the ankle

          Arthritis of the ankle joint is an inflammatory process that occurs when infectious agents penetrate the cartilage tissue of the ankle joint. The penetration of infection can be associated either with a direct hit during injury, or indirectly, through the lymph and bloodstream.

          Many people are familiar with the sight of swollen ankles with redness and the inability to put on their usual shoes. The disease can occur after an injury or in response to long-term use of medications that weaken one’s own immunity.

          A slight aching pain can develop into a sharp one, which will not give rest even during a horizontal position.

          The ICD 10 code will depend on the etiology of the pathological process:

        • M02 – reactive arthritis, the most common manifestation of the disease in men and women;
        • M05 and M06 - contain general symptoms of arthropathy, including those applicable to pathology in the ankle area;
        • M08 and M09 – juvenile arthritis (children, adolescents);
        • M10 – gouty arthritis.
        • For all types of arthritis, a coding with values ​​M00-M25 is assigned.

          • Gouty arthritis of the ankle joint. The reasons for the development lie in metabolic disorders, in particular the deposition of uric acid salts in the cartilage cavity.
          • Rheumatoid arthritis of the ankle. Systemic disease. Hereditary predisposition plays a major role in the risk of development. Most often, pathology develops as a consequence of infection entering the body and only then into the joint cavity. The ankle area swells, the person feels aching pain.
          • Reactive arthritis of the ankle. The cause of development may be the development of infection in the intestines or genitourinary system. It manifests itself as slight swelling, stiffness in the joint, and slight pain.
          • Acute arthritis of the ankle joint. The cause of development is damage to bone tissue by infectious pathogens. The pain is sharp, swelling is pronounced. Acute arthritis is characterized by high fever, and the patient may experience chills and fever. This course of the disease requires the immediate intervention of a doctor and the prescription of a set of therapeutic measures aimed at alleviating the patient’s condition and relieving the consequences of the inflammatory process.
          • Purulent arthritis develops when infection penetrates into the soft tissues of the joint cavity. Often develops as a consequence of acute arthritis. When a puncture is taken, suppuration is present in the exudate. The inflammation is pronounced, swelling and redness of the ankle, pain when moving the foot. The formation of suppuration is dangerous because there is a risk of infection entering the general bloodstream and transfer of infectious agents to other joints of the body - general arthritis.
          • Post-traumatic arthritis of the ankle. A common problem for professional athletes, who are characterized by frequent microtraumas, dislocations and bruises of the ankle joint. The infection occurs indirectly and inflammation develops against the background of minor tissue damage.
          • Stress arthritis. Develops under the influence of regular increased loads on the ankle joints. Frequent injuries, bruises and dislocations contribute to the development. People with scoliosis and excess body weight are at risk, since in this case the load will be distributed unevenly and the joints will suffer. This also includes the stress on the joint associated with wearing high heels.
          • It is important to know! Rheumatoid and stress-related arthritis are the most common causes of ankle inflammation. If you are at risk, you need to carefully monitor the load you receive and, if possible, take preventive measures that will help strengthen your ankle and increase the body’s resistance to various infections.

            Signs of the development of ankle arthritis are similar to those affecting other joints.

          • The acute development of the disease is expressed in intense symptoms: the development of edema, increased temperature, up to 39-40°C. Inflammation is characterized by pronounced redness of the skin, which is characteristic, among other things, of the beginning of the process of suppuration.
          • The chronic course of the disease can occur without swelling and fever, but pain and stiffness in the ankle will be especially disturbing at night and in the morning.
          • If the patient ignores the symptoms and avoids seeing a doctor in every possible way, then in a couple of years he runs the risk of complete destruction of the ankle joint.

            The advanced state of the disease is indicated by pronounced muscle atrophy in the ankle area, expressed in a noticeable decrease in girth in the area of ​​the joint.

            The patient may also complain of a deterioration in general health, weakness and lethargy caused by intoxication of the body. You should be wary of pain when flexing and extending the ankle joint, and the inability to put on your usual shoes.

            The most common triggers for ankle arthritis are bruises and injuries. However, doctors identify a number of other reasons contributing to the development of the disease:

          • sports and professional activities associated with stress on the ankle joint;
          • development under the influence of other pathologies of the ankle joint. For example, as a consequence of flat feet.
          • consequences of bad habits.
          • hypothermia;
          • uncomfortable, tight shoes, excessively high heels;
          • disturbances in the functioning of the endocrine glands and changes in hormonal levels;
          • disturbances in metabolic mechanisms;
          • infections;
          • excess body weight;
          • genetic predisposition;
          • autoimmune pathologies;
          • allergy.
          • We have a very impressive list that shows how serious the risk of arthritis is, because, in fact, even a seemingly insignificant respiratory virus can provoke inflammation.

            Treatment of ankle arthritis

            The first thing that needs to be done during an exacerbation of arthritis is to provide rest to the joint, relieve the patient from pain and stop the development of inflammatory processes.

            Ankles that become swollen during exacerbation of arthritis can be returned to normal using folk remedies. What can be done to restore functionality to the ankle joint at home?

            First, immobilize the joint. A fixing bandage will make it possible to provide rest to the inflamed area, which will significantly alleviate the condition.

            Secondly, poultices and compresses are actively used to relieve pain, get rid of swelling and reduce the manifestation of the inflammatory process. Baths made from fresh spruce needles and flax seeds in the form of a compress have proven themselves well. Also often onion pulp, cabbage leaves, and honey are applied to the large joint.

            Warming ointments and tinctures, together with insulation, can relieve pain and reduce inflammation.

            It should be noted that in case of acute purulent arthritis, experiments with traditional medicine can only lead to complications.

            In order for the prognosis to become favorable, it is necessary to use drug treatment together with physiotherapy, massage, and physical therapy.

            Therapy is carried out comprehensively, taking into account the individual characteristics of the disease in a particular patient. In advanced cases, surgical intervention may be required to pump out pus from the joint cavity and wash it with antibiotics.

            Antibiotics for ankle arthritis are indicated to eliminate infectious agents and prevent the spread of pathogenic pathogens to similar tissues in other joints.

            It is preferable to inject drugs intramuscularly or inject directly into the joint cavity. Such local injections promote effective action directly on the site of inflammation and help prevent the development of side effects of drugs.

            Antibiotic treatment lasts up to 30 days. This duration is due to the need to completely rid the body of the presence of pathogens.

            Warming ointments help relieve pain, relieve inflammation and increase blood microcirculation in the area of ​​the affected joint, which has a beneficial effect on recovery processes.

            Diet is one of the additional factors influencing the condition of the joints. Often the cause of inflammation is disturbances in metabolic processes. Changing your diet allows you to enrich your diet with the required nutrients. Chondroprotective supplements can be added to the diet to restore damage to the joint and restore elasticity.

            Massage and a complex of exercise therapy can help relieve swelling in ankle arthritis after the inflammation has been removed and the temperature has been reduced to an acceptable level. Specific exercises are selected by the attending physician. First, the patient performs the complex under the supervision of a specialist, after which he can do it independently.

            Immunomodulatory therapy is of great importance, because a course of hormonal drugs and antibiotics has a detrimental effect on the body’s own microflora. The formation of immunity will prevent relapses of the disease by strengthening the body's resistance.

            Ankle arthritis in children

            Children are very dynamic in their development and curiosity. At the same time, their ligamentous and muscular apparatus is not yet fully strengthened, which can cause repeated damage to the ankle joint due to dislocations and subluxations. We cannot exclude bruises and wounds, which can cause infection to enter the joint cavity.

            As a preventive measure, it is important to purchase comfortable shoes for children with high-quality ankle support. This will help avoid injury, which means the risk of developing arthritis will be reduced.

            Parents are advised to pay attention to even minor injuries that the child receives. Each can become a trigger for the penetration of pathogenic microflora into the joint cavity and cause an inflammatory process. Be sure to make a follow-up visit to the traumatologist, especially if the child complains of pain after the visible signs of the injury have disappeared.

            We remember that inflammation of the ankle joint can be caused by the penetration of an infectious pathogen. This could be ARVI, intestinal infection, diseases of the genitourinary system. The only way to protect a child from disease is to stimulate the functioning of his immune system so that the body can resist viruses and pathogenic bacteria.

            Important signals will be redness and swelling of the soft tissues in the ankle area, and mobility is impaired. If the child is already walking, there will be lameness. The baby will noticeably take care of his leg and will stop running and jumping.

            If you discover a symptom, consult a doctor as soon as possible to identify the cause of the disease and begin treatment. Remember that delay has a detrimental effect on the child’s joint. Early detection promotes full recovery.

            Ankle arthritis can affect more than just older, overweight people. At risk are children and adolescents with weak ankles, prone to frequent bruises and injuries; workers who have to carry heavy loads, as well as specialists who spend most of the working day on their feet.

            Frequent colds and hypothermia also have a detrimental effect on ankle health. A weakened immune system opens the way for infections that can easily infect cartilage tissue. Arthritis also threatens those who are the epitome of a healthy lifestyle - athletes whose achievements mean daily extreme stress on the ankle.

            Timely recognition of symptoms allows treatment to be carried out more effectively than to deal with the devastating consequences that threaten complete destruction of the cartilage. A healthy ankle is a guarantee of your freedom of movement!

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